Abstract
A retrospective, nonrandomized, interventional case series of 8100 patients with uveal melanoma were evaluated for melanoma-related metastasis based on patient race. The patient race was Caucasian (n=7918, 98%), Hispanic (n=105, 1%), Asian (n=44, <1%), or African American (n=33, <1%). On the basis of race (Caucasian, Hispanic, Asian, and African American), significant differences were noted in mean age at presentation (58, 48, 44, and 52 years; P<0.001), distance of posterior tumor margin to foveola (5, 5, 6, and 4 mm; P<0.001), distance of posterior tumor margin to optic disc (5, 5, 6, and 4 mm) (P<0.001), tumor base (11, 12, 12, and 13 mm; P<0.001), tumor thickness (5.4, 7.1, 6.5, and 7.5 mm; P<0.001), intraocular hemorrhage (10, 14, 11, and 24%; P=0.02), and rupture of Bruch’s membrane (20, 27, 39, and 36%; P=0.001). On the basis of multivariate analysis, the rate of metastasis increased with increasing age (P<0.001), ciliary body location (P<0.001), increasing tumor base (P<0.001), increasing tumor thickness (P<0.001), pigmented tumor (P=0.001), subretinal fluid (P=0.001), intraocular hemorrhage (P=0.045), and extraocular extension (P=0.036). Kaplan–Meier estimates of metastasis at 3, 5, and 10 were 8, 15, and 25% in Caucasians; 13, 13, and 13% in Hispanics; 4, 4, and 36% in Asians; and 8, 8, and 8% in African Americans. Compared with Caucasians, despite relative risk for metastasis of 0.31 for African Americans, 0.73 for Hispanics, and 1.42 for Asians, there was no statistical difference in metastasis, or death from uveal melanoma based on race. In summary, uveal melanoma showed similar prognosis for all races.
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Acknowledgements
Support provided by a Wills Innovation Grant, Philadelphia, PA, USA (CLS MNC, JAS), Eye Tumor Research Foundation, Philadelphia, PA, USA (CLS, JAS). Statistical analysis provided by Rishita Nutheti, Ph.D., Hyderabad, India. The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review or approval of the manuscript. CLS, M.D. has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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Presented in part as the 2015 Doyne Lecture at the Oxford Ophthalmological Congress, Oxford, England, 5 July 2015 to 8 July 2015. (CLS)
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Shields, C., Kaliki, S., Cohen, M. et al. Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne Lecture. Eye 29, 1027–1035 (2015). https://doi.org/10.1038/eye.2015.51
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DOI: https://doi.org/10.1038/eye.2015.51
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